14 crc certified risk adjustment coder jobs found in Orange, CA

Location: Orange, California, United StatesCompany: Alignment Healthcare USA, LLCPosted: 2026-08-11Alignment Health is seeking an experienced MRA Coding Auditor to support QA audits of the internal Coding Analyst Team and vendors, ensuring high-quality data submitted to CMS. The role involves risk adjustment data validation, chart reviews, and process improvements.Required: 3+ years Medicare Risk Adjustment coding, certified coder (CCS/CCS-P/CPC/CRC/RHIT/RHIA), and proficiency with MS Office and leading EHR systems. This is a remote position with competitive pay and benefits.#J-18808-Ljbffr

Alignment Health is seeking an experienced MRA Coding Auditor to support QA audits of the internal Coding Analyst Team and vendors, ensuring high-quality data submitted to CMS. The role involves risk adjustment data validation, chart reviews, and process improvements. Required: 3+ years Medicare Risk Adjustment coding, certified coder (CCS/CCS-P/CPC/CRC/RHIT/RHIA), and proficiency with MS Office and leading EHR systems. This is a remote position with competitive pay and benefits. #J-18808-Ljbffr

Astrana Health Management is seeking a Risk Adjustment Coding Specialist II to support the Orange County market. Candidates should have 3-5 years of risk adjustment coding experience and be able to travel up to 75% for the role. You will review provider documentation, conduct education sessions, and ensure compliance with coding regulations. AAPC or AHIMA certification is required. The role offers a competitive salary range of $70,000 - $85,000 per year. #J-18808-Ljbffr

Astrana Health is seeking a Risk Adjustment Coding Specialist to support Orange County operations. You will conduct high-volume chart reviews to identify coding gaps, then translate findings into education for providers and practice leaders, driving HCC recapture and KPI improvements. olla You will travel to provider offices up to 75% and collaborate with IPA teams, offering auditing and education to ensure CMS, Medicare and payer guidelines are met while staying current on ICD-10/HCC updates. #J-18808-Ljbffr

Clever Care Health Plan is hiring a Risk Adjustment Coding Auditor to conduct retrospective and prospective coding audits, validate diagnoses, and monitor CMS RADV compliance. The role focuses on HCC coding, documentation improvement, and education for providers across a fast-growing Medicare Advantage program. Candidates should have 5+ years in MA risk adjustment or related audits, with strong knowledge of ICD-10-CM guidelines and MEAT criteria. #J-18808-Ljbffr

Astrana Health in Monterey Park, CA is seeking a Risk Adjustment coder to review and ensure accurate ICD-10-CM/HCC documentation across Medicare Advantage, ACA, and commercial lines. You will educate providers and work with IPAs to improve coding quality. You will travel up to 75% and balance on-site fieldwork with hybrid support, maintaining up-to-date knowledge of CMS guidelines and payer requirements while meeting productivity targets. #J-18808-Ljbffr

Astrana Health, Inc. in Monterey Park, CA is seeking a Risk Adjustment Coding Specialist II to verify provider documentation, educate providers, and support CMS risk adjustment initiatives. The role requires travel to provider sites (about 75%) and reports to the Supervisor - Risk Adjustment. Requires CCS/CPC or similar certification and 3+ years of risk adjustment coding, with strong ICD-10-CM/HCC knowledge and EHR proficiency. Competitive salary is $75,000–$85,000 per year. #J-18808-Ljbffr

Astrana Health seeks a Risk Adjustment Coding Specialist II to join our Strategy and Operations team in Monterey Park, CA. The role requires converting provider documentation into compliant HCC coding and educating providers on CMS requirements while traveling to provider sites as needed. Qualified candidates hold CCS/CPC certification with 3+ years of risk adjustment coding experience, strong EHR skills, and the ability to work in a hybrid setting, including on-site visits and remote #J-18808-Ljbffr

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to support our physician practices remotely. You will perform high-volume chart reviews to identify coding gaps and improve accuracy, translating findings into education for providers and practice leaders while tracking KPIs such as HCC recapture and AWVs. The ideal candidate has 3–5 years of risk adjustment experience, CPC/CRC credentials, and strong communication skills to educate and collaborate with provider teams. #J-18808-Ljbffr

This position operates on a hybrid work schedule. Candidate must reside in Los Angeles or Orange County. Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth. Who Are We? Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values. Why Join Us? We’re on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you’ll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation. Job Summary The Risk Adjustment Coding Auditor is responsible for conducting...

Job Details Location: Huntington Beach Office, Huntington Beach, CA 92647. Position Type: Full Time. Salary Range: $72,800.00 – $80,000.00. This position operates on a hybrid work schedule. Candidate must reside in Los Angeles or Orange County. Job Summary The Risk Adjustment Coding Auditor is responsible for conducting retrospective and prospective coding audits, diagnosis validation reviews, provider documentation assessments, and compliance monitoring activities to support accurate Medicare Advantage risk adjustment reporting and CMS audit readiness. This role reviews medical record documentation and ICD-10-CM diagnosis coding to ensure compliance with CMS Risk Adjustment program requirements, Official Coding Guidelines, AHA Coding Clinic guidance, and organizational policies. Functions & Responsibilities Conduct retrospective, prospective, and targeted coding audits to assess the accuracy, completeness, and compliance of ICD-10-CM diagnosis coding and HCC capture....

Join to apply for the Compliance Coding Auditor , ATM role at Advanced Medical Management, Inc. Your actual pay will be based on your skills and experience. Talk with your recruiter to learn more. Base pay range: $75,000 to $80,000 per year. Role Overview As a member of AMM’s Compliance and Ethics team, the Compliance Coding Auditor is an important driver of our mission. They are responsible for supporting the Company’s Compliance & Ethics Program (the Program) auditing, tracking, and monitoring initiatives. Robust auditing, testing, and monitoring capabilities are essential to fulfilling the expectations of AMM’s key stakeholders, including patients, families, and government agencies. The Program is led by AMM’s Chief Compliance & Ethics Officer, who reports to the CEO and the Board, and oversees the AMM Compliance Committee. This role requires sound, risk‑aware judgment, productive collaboration across the Company, and demonstrated success in performing audits to...

Description About Us Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members. SUMMARY The Junior Quality Improvement Coder is responsible for providing director support to all departmental QI initiatives. In this role, the Junior QI Coder will partner with the Director to collaborate with network providers and IPA’s to improve the quality of care through quality improvement activities that will include RAF, HEDIS, CMS Star Ratings and other health plan reporting. ESSENTIAL DUTIES AND RESPONSIBILITIES Analyze data from contracted IPA network providers that allows for proper review of data to evaluate HEDIS and Risk...

DRG Coder The Senior DRG Coder is responsible for reviewing inpatient medical records and accurately assigning diagnosis and procedure codes using ICD-10-CM and ICD-10-PCS to determine the appropriate Diagnosis-Related Group (DRG) assignment. This role ensures coding accuracy, reimbursement integrity, and compliance with federal and state regulations, payer guidelines, and internal policies. In an Independent Practice Association (IPA) and Management Services Organization (MSO) environment, the Senior DRG Coder partners with utilization management, care management, finance, and provider network teams to support accurate payment, risk adjustment, quality reporting, and medical expense analysis. What You'll Do Review inpatient hospital records and assign accurate diagnosis and procedure codes Determine the appropriate MS-DRG or APR-DRG assignment based on coding and clinical documentation Conduct coding validation and auditing to ensure compliance with payer and regulatory...